EP2155071B1 - Medical devices and systems for closing perforations - Google Patents

Medical devices and systems for closing perforations Download PDF

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Publication number
EP2155071B1
EP2155071B1 EP08756124.7A EP08756124A EP2155071B1 EP 2155071 B1 EP2155071 B1 EP 2155071B1 EP 08756124 A EP08756124 A EP 08756124A EP 2155071 B1 EP2155071 B1 EP 2155071B1
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EP
European Patent Office
Prior art keywords
plurality
medical device
tubes
distal
tissue
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP08756124.7A
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German (de)
French (fr)
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EP2155071A1 (en
Inventor
Vihar C. Surti
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Cook Medical Technologies LLC
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Cook Medical Technologies LLC
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Publication date
Priority to US94024607P priority Critical
Application filed by Cook Medical Technologies LLC filed Critical Cook Medical Technologies LLC
Priority to PCT/US2008/064508 priority patent/WO2008147871A1/en
Publication of EP2155071A1 publication Critical patent/EP2155071A1/en
Application granted granted Critical
Publication of EP2155071B1 publication Critical patent/EP2155071B1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482Needle or suture guides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00637Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for sealing trocar wounds through abdominal wall
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00646Type of implements
    • A61B2017/00663Type of implements the implement being a suture
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0472Multiple-needled, e.g. double-needled, instruments

Description

    FIELD OF THE INVENTION
  • The present invention relates generally to medical devices, and systems for closing perforations in tissue.
  • BACKGROUND OF THE INVENTION
  • Perforations in the walls of internal organs and vessels may be naturally occurring, or formed intentionally or unintentionally. In order to permanently close these perforations and allow the tissue to properly heal, numerous tissue fixation devices and methods have been developed employing sutures, adhesives, clips, staples and the like. One class of such devices is commonly referred to as T-anchors, also known as tissue anchors or visceral anchors. An exemplary tissue anchor is disclosed in U.S. Pat. No. 5,123,914 . Such tissue anchors have been very successful in medical procedures requiring visceral wall mobilization or wall apposition.
  • Tissue anchors have also been successfully used in closing perforations, but are not without their drawbacks. For example, when a series of anchors are placed around a perforation, each individual anchor is manually placed in sequence. This can be time consuming, and can result in uneven spacing of the anchors around the perforation. It can therefore be difficult to ensure proper approximation of the tissue around the perforation and complete closure thereof. This is especially critical within the gastrointestinal tract, where the travel of bacteria laden fluids outside of the tract may cause unwanted and sometimes deadly infection.
  • U.S. Patent Application Publication No. 2001/021855 discloses a tissue fixation delivery system having the features of the preamble of claim 1.
  • BRIEF SUMMARY OF THE INVENTION
  • The present invention provides medical devices, and systems for placing tissue fixation devices that are easy to employ, reduce procedure time, and improve spacing of the tissue fixation devices. One embodiment of a medical device, constructed in accordance with the teachings of the present invention, includes a plurality of elongate delivery devices, a plurality of elongate tubes, and a distal tip as determined by the appended claim 1. Preferably the delivery devices are needles, although other devices may be used for delivering tissue fixation devices. Each delivery device defines a delivery lumen sized to receive a tissue fixation device. The plurality of elongate tubes extend generally parallel to a longitudinal axis, and each tube defines a tube lumen sized to receive one of the delivery devices. Each tube lumen has a distal port. The distal tip is connected to the plurality of elongate tubes and defines a guide surface positioned distally of the distal ports. The guide surface is structured to redirect the plurality of delivery devices radially outwardly as the plurality of delivery devices are distally translated through the tube lumens and the distal ports of the plurality of elongate tubes.
  • According to more detailed aspects of the medical device, the guide surface slopes radially outwardly, and preferably is curved. The guide surface redirects the plurality of delivery devices in a direction angled relative to the longitudinal axis, preferably angled in the range of 10 to 60 degrees, and most preferably about 30 degrees. The distal tip defines a hub having a plurality of pockets sized to receive the plurality of elongate tubes. An end surface of the distal tip is atraumatically shaped. Preferably, the delivery devices are puncture needles, and the tissue fixation devices are tissue anchors.
  • A medical system for placing tissue fixation devices in bodily tissues is also provided. According to one embodiment of the medical system, the system includes a plurality of elongate delivery devices, a plurality of elongate tubes, a distal tip, and an endoscope. The plurality of delivery devices each define a delivery lumen sized to receive a tissue fixation device. The plurality of elongate tubes extend generally parallel to a longitudinal axis and each tube defines a tube lumen sized to receive one of the plurality of delivery devices. Each tube lumen defines a distal port. A distal tip is connected to the plurality of elongate tubes and defines a guide surface positioned distally of the distal ports and extending radially outwardly. The distal tip defines a passageway. The endoscope is selectively attachable to the distal tip, and the passageway is sized to receive a distal end of the endoscope therein.
  • According to more detailed aspects of the medical system, the endoscope is loosely press fit within the passageway of the distal tip. The passageway defines an inner surface, and the inner surface is positioned to frictionally engage the endoscope. The plurality of tubes extend along an outer surface of the endoscope. The guide surface is structured to redirect the plurality of delivery devices radially outwardly as the plurality of delivery devices are distally translated through the tube lumens and the distal ports of the plurality of elongate tubes.
  • BRIEF DESCRIPTION OF THE DRAWINGS
    • FIG. 1 is a plan view, partially cut-away, showing a medical device constructed in accordance with the teachings of the present invention;
    • FIG. 2 is a front view, partially in cross-section, showing a medical system including the medical device depicted in FIG. 1, constructed in accordance with the teachings of the present invention;
    • FIG. 3 is an enlarged cross-sectional view, partially cut away, of the distal end of the medical device depicted in FIG. 1;
    • FIG. 4 is an enlarged cross-sectional view, partially cut away, of the distal end of the medical system depicted in FIG. 2; and
    • FIGS. 5, 6 and 7 are enlarged cross-sectional views similar to FIG. 4 showing operation of the medical system.
    DETAILED DESCRIPTION OF THE INVENTION
  • Turning now to the figures, FIG. 1 depicts a medical device 20 constructed in accordance with the teachings of the present invention. As shown in FIG. 2, the medical device 20 also forms part of a medical system 22, which includes the medical device 20 and an endoscope 24. Generally, the medical device 20 is selectively attachable to the endoscope 24, and the medical system 22 may be traversed through a bodily lumen of a patient to a desired location for performing procedures within the body, such as at a particular bodily wall or tissue. As depicted in FIG. 2, the bodily lumen may be the esophagus 10 while the bodily tissue may be the gastric wall 12, although the medical system 22 may be used with any bodily lumen and tissue, as will be understood by those skilled in the art.
  • Turning back to FIG. 1, the medical device 20 generally includes a plurality of puncture needles 30 and a plurality of tubes 32. The plurality of needles 30 have at their proximal end a plurality of needle housings 34, while the proximal end of the plurality of tubes 32 includes a plurality of tube housings 36. As is known to those skilled in the art, the relative positions of the needle housings 34 and the tube housings 36 control the relative positions of the needles 30 within the protective tubes 32. In this manner, the needles 30 may be operated to project from a distal end of the tubes 32, or operated to be retracted within the tubes 32, as will be described in more detail hereinbelow. The proximal end of the medical device 20 also includes a plurality of plungers 38 which are connected to stylets 40 (FIG. 3) that extend through the plurality of needles 30. The stylets 40 (operated via their plungers 38) are used to push tissue fixation devices such as tissue anchors 54 (FIG. 3) out from the distal ends of the needles 30.
  • With reference to FIGS. 1 and 3, the plurality of tubes 32 are connected to a distal tip 42 at the distal end of the tubes 32. The distal tip 42 generally includes a plurality of hubs 44 defining a plurality of pockets 46 for receiving the plurality of tubes 32, as best seen in FIG. 3. The hubs 44 could be a single hub having a plurality of pockets 46, or as shown in FIG. 2, individual and discreet hubs 44 may be designed to define the plurality of pockets 46. Each hub 44 defines a shoulder 48 at the bottom of the pocket 46 for abutting a distal end of each tube 32. The distal tip 42 and plurality of tubes 32 may be interconnected through frictional engagement, adhesives, welding, soldering or any other well known means for connecting two structures. The hubs 44 define distal ports 55 through which the plurality of needles 30 extend and are exposed for placement through the bodily tissue 12. It will be recognized by those skilled in the art that the distal tip 42 may simply have the plurality of tubes 32 attached to its exterior surface, thereby eliminating the hub or hubs 44 and their pockets 46. In this case, the plurality of tubes 32 themselves would define the distal ports 55 though which the needles 30 can exit. The distal ports 55 are circumferentially spaced about the distal tip 42. Preferably the distal ports 55 are equidistantly spaced to provide for delivery of the tissue anchors 54 in a generally equidistantly spaced configuration, although different spacings may be designed, such as to match the shape of the perforation 16 (FIG. 7) in the tissue 12, which can be elongated or otherwise uneven, rather than circular.
  • As also best seen in FIG. 3, the plurality of tubes 32 each define a tube lumen 58 which slideably receives the needles 30 therein. Similarly, the needles 30 each define a needle lumen 52 which is sized to receive the stylet 40. A distal end 31 of each needle 30 contains one or more tissue anchors 54 positioned within the needle lumen 52. The distal end 31 also includes a slot 33 through which the suture 56 passes. The suture 56 is connected to the tissue anchor 54 and is used to draw the perforation 16 (FIG. 7) closed, as is known in the art. It can be seen in FIG. 3 that the suture 56 extends proximally through the tube lumen 58 between the needle 30 and tube 32. It will also be recognized by those skilled in the art that the suture 56 could alternatively pass through the interior of the needle 30, i.e., through the needle lumen 52. The tissue anchors 54 may be pre-loaded within the needles 30, and likewise the needles may be pre-loaded within the plurality of tubes 32, although this is not necessary.
  • Notably, various types and designs of tissue anchors 54 may be employed in conjunction with the present invention, exemplary tissue anchors being disclosed in U.S. Patent No. 5,123,914 ; and U.S. Provisional Patent Application No. 60/872,023 , now published as WO 2008/067384 . It will also be recognized that the medical device 20 and medical system 22 of the present invention may also be used in conjunction with other tissue fixation devices such as staples, an exemplary tissue staple and system being disclosed in U.S. Patent Application No. 60/956,580 , now published as WO 2009/026076 . Accordingly, it will be seen that the plurality of puncture needles 30 can be replaced with other elongate delivery devices, such as delivery catheters for tissue staples, dependent upon the particular tissue fixation device.
  • As best seen in FIGS. 3 and 4, the distal tip 42 includes an interior passageway 60 defined by an interior wall 62. As shown in FIG. 4, the passageway 60 and interior wall 62 are sized to receive an endoscope therein for forming the medical system 22 of the present invention. In the depicted embodiment, the passageway 60 and wall 62 are sized to be loosely press-fit with the endoscope 24 such that they are selectively attachable, although it will be recognized by those skilled in the art that many different structures and means for selectively attaching the endoscope 24 to the medical device 20 may be employed. An end surface 66 of the distal tip is atraumatically shaped, i.e. rounded, such that the medical system 22 may be safely navigated through the patient's bodily lumens.
  • It can also be seen that the plurality of tubes 32 and needles 30 generally extend along a longitudinal axis 14 that is also shared by the distal tip 42. The plurality of tubes 32 are elongated and structured to extend longitudinally along the outer surface of the endoscope 24, as shown in FIG. 2. A band 23 or other structure may be used to connect the plurality of tubes 32 to the endoscope 24 at points along the length of the medical system 22, although such bands 23 or the like are not necessary to traverse the medical system 22 through the bodily lumen 10. It will also be recognized that the endoscope 24 can be integrally formed with the medical device 20, namely with the plurality of tubes 32 and distal tip 42. For example, the distal tip 42 and/or plurality of tubes 32 can be bonded to the endoscope 24, such as with an adhesive or using welding techniques.
  • An outer surface of the distal tip 42 defines a guide surface 64. Generally, the guide surface 64 extends radially outwardly and is positioned distally of the distal port 55. As best seen in FIG. 5, as the plurality of needles 30 are distally translated relative to the plurality of tubes 32, the needles 30 project from the distal port 55 and engage the guide surface 64. The guide surface 64 extends radially outwardly and deflects the needles 30 radially outwardly, as indicated by arrow 70. As shown in FIG. 6, upon further translation in the distal direction, the needles 30 continue to flex and are directed radially outwardly. The hubs 44 define slots 50 that open radially, and the slots 50 provide increased range of movement to the needles 30 as they flex. In an embodiment where the plurality of tubes 32 are simply attached to the exterior surface of the distal tip 42 (i.e. without the hub 44 and pockets 46) these slots 50 may be formed in the tubes 32 themselves. As such, the needles 30 enter the slots 50 defined by the hub 44 and pockets 46, thereby permitting greater range of movement and preventing excessive flexing or bending of the needles 30.
  • Accordingly, the distal tip 42 and its guiding surface 64 move each of the needles 30 radially outwardly away from each other and away from the longitudinal axis 14. While the figures have depicted the guide surface 64 as curved, and generally a bell-shaped curve, it will be recognized by those skilled in the art that the guiding surface 64 may take many different curvatures, or can even be flat, such as in a conical or pyramidal shape (i.e. flat in the longitudinal direction). Further, the outer diameter of the distal tip 42 at its peak 65 may also be increased or decreased to increase or decrease the amount of deflection of the plurality of needles 30. The peaks 65 are preferably spaced radially outwardly of the distal ports 50. Preferably, the distal tip 42 and its guiding surface 64 are structured to cause the needles 30 to be passed through the tissue 12 at an angle of about 10 to 60 degrees relative to the longitudinal axis 14. Most preferably, the needles 30 are at an angle of about 30 degrees relative to the longitudinal axis 14. Further, the needles 30 are in paths that are circumferentially spaced apart, and preferably equidistantly spaced apart, thereby greatly improving the spacing of the tissue anchors 54 around a perforation 16 (FIG. 7) and improving perforation closure.
  • An exemplary method for placing tissue fixation devices in bodily tissue 12 of a patient will now be described with reference to FIGS. 2 and 5-7. A medical system 20 is provided, such as the medical device 20 and endoscope 24 as previously discussed. The endoscope 24 is attached to the medical device 20, namely by placing the distal end of the endoscope 24 into the interior passageway 60 of the distal tip 42. The medical system 20 is introduced through a bodily lumen 10 of the patient to a position proximate the bodily tissue 12, as shown in FIG. 2. The plurality of puncture needles 30 are translated distally through the plurality of tubes 32 such that the plurality of needles 30 engage the guide surface 64 and deflect radially outwardly, as shown in FIG. 5 and indicated by arrow 70. As shown in FIG. 6, the plurality of puncture needles 30 are passed through the bodily tissue 12. This may occur sequentially or simultaneously. It will be recognized by those skilled in the art that because the distance between each of the needles 30 increases in the longitudinal direction (i.e. the more distal the greater the spacing), the medical system 22 and its distal tip 42 may be placed closer to the tissue 12 to bring the placement sites closer together, or the medical system 22 may be moved further away from the tissue 12 to increase the distance between the placement sites. In devices where other types of tissue fixation devices and delivery devices are employed (e.g. a visceral staple and delivery catheter, respectively) the delivery device need only be positioned proximate the tissue 12, and need not pass through the tissue 12.
  • Once the plurality of puncture needles 30 have been passed through the bodily tissue 12, as shown in FIG. 6, the plurality of tissue anchors 54 are delivered to a position on the distal side of the bodily tissue 12. In the depicted example, the tissue anchors 54 are connected to suture 56, and the anchors 54 are ejected from the distal end of the needles 30 through translation of the stylets 40 via depression of the plungers 38 (FIG. 1). As shown in FIG. 7 and indicated by arrow 72, the plurality of puncture needles 30 are then retracted into the plurality of tubes 30, leaving the tissue anchors 54 in place.
  • If desired, a cutting instrument 68 may then be delivered through the accessory channel 25 of the endoscope 24, and used to form an opening 16 in the tissue 12. Preferably, the cutting tool 68 is an electrosurgical cutting instrument, although it will be recognized by those skilled in the art that any type of cutting instrument or device may be employed. Preferably, the exemplary step of forming the opening 16 is performed after the exemplary step of translating the puncture needles 30 and most preferably after delivering the plurality of tissue anchors 54, thereby reducing the potential for the tissue 12 to deflect or move when placing the tissue anchors 54. However, the plurality of tissue anchors 54 or other tissue fixation devices may be delivered after the opening 16 has already been formed in the tissue 12. In either case, the tissue 12 (and sometimes the opening 16) is preferably visualized using the endoscope 24 prior to placing the plurality of puncture needles 30 through the bodily tissue 12.
  • The medical system 22 may be retracted through the bodily lumen 10, and the endoscope 24 may be detached from the medical device 20. If desired, the endoscope 24 may then be reintroduced through the bodily lumen 10 and through the opening 16 in the bodily tissue 12. As such, various procedures may be employed with, or in conjunction with, the endoscope 24 on the distal side of the bodily tissue 12. It will also be recognized that various other medical devices may be passed through the bodily lumen 10 and through the opening 16 formed in the bodily tissue 12. When the procedure(s) on the distal side of the opening 16 are complete, the one or more sutures 56 attached to the tissue anchors 54 are connected together, such as by using a suture lock. Exemplary suture locks are disclosed in U.S. Patent Application Nos. 60/941,086 and 60/956,575 now published as WO 2008/147875 and WO 2009/026078 respectively. Through fixation of the sutures 56, the perforation 16 can be easily and securely closed.
  • The foregoing description of various embodiments of the invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise embodiments disclosed. Numerous modifications or variations are possible in light of the above teachings. The embodiments discussed were chosen and described to provide the best illustration of the principles of the invention and its practical application to thereby enable one of ordinary skill in the art to utilize the invention in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the invention as determined by the appended claims when interpreted in accordance with the breadth to which they are fairly, legally, and equitably entitled.

Claims (12)

  1. A medical device (20) for placing tissue fixation devices (54) in bodily tissue (12), the medical device (20) comprising:
    a plurality of elongate delivery devices (30), each delivery device (30) defining a delivery lumen (52) sized to receive a tissue fixation device (54);
    a plurality of elongate tubes (32) extending generally parallel to a longitudinal axis (14), each tube (32) defining a tube lumen (58) sized to slidably receive one of the plurality of delivery devices (30), each tube lumen (58) ending proximate a distal port (55); and
    a distal tip (42) positioned distally of the distal ports (55), the outer surface of the distal tip (42) defines a guide surface (64) structured to redirect the plurality of delivery devices (30) radially outwardly as the plurality of delivery devices (30) are distally translated through the tube lumens (58) and the distal ports (55) of the plurality of elongate tubes (32);
    characterised in that
    the distal tip (42) defines one or more hubs (44) having a plurality of pockets (46) sized to receive the plurality of tubes (32), wherein the distal tip (42) and the plurality of tubes (32) are interconnected through frictional engagement, adhesives, welding or soldering.
  2. The medical device (20) of claim 1, wherein the guide surface (64) slopes radially outwardly.
  3. The medical device (20) of claim 1, wherein the guide surface (64) is curved.
  4. The medical device (20) of claim 1, wherein the guide surface (64) redirects the plurality of delivery devices (30) in a direction angled relative to the longitudinal axis (14).
  5. The medical device (20) of claim 4, wherein the guide surface (64) redirects the plurality of delivery devices (30) in a direction angled about 30 degrees relative to the longitudinal axis (14).
  6. The medical device (20) of claim 1, wherein the plurality of elongate tubes (32) are equidistantly spaced circumferentially about the distal tip (42).
  7. The medical device (20) of claim 1, wherein the plurality of delivery devices (30) include a plurality of puncture needles, and wherein the plurality of tissue fixation devices (54) include a plurality of tissue anchors.
  8. The medical device (20) of claim 1, wherein each hub (44) has a bore extending therethrough, proximal portions of the bores defining the pockets (46) and distal portions of the bores (50) defining the distal ports (55), and wherein each hub (44) defines a longitudinal slot (50) in communication with the bore and opening radially, each longitudinal slot (50) sized to receive one of the delivery devices (30) therein.
  9. The medical device (20) of claim 1, wherein each delivery device (30) slides within its elongate tube (32) independently of the other delivery devices (30).
  10. The medical device (20) of claim 1, wherein each hub (44) defines a shoulder (48) at the bottom of each pocket (46) for abutting a distal end of each of the plurality of tubes (32).
  11. A medical system (22) including the medical device (20) of any preceding claim and further comprising an endoscope (24) selectively attachable to the distal tip (42), wherein the distal tip (42) defines a passageway (60) sized to receive a distal end of the endoscope (24) therein.
  12. The medical system (22) of claim 11, wherein the plurality of tubes (32) extend along an outer surface of the endoscope (24).
EP08756124.7A 2007-05-25 2008-05-22 Medical devices and systems for closing perforations Active EP2155071B1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US94024607P true 2007-05-25 2007-05-25
PCT/US2008/064508 WO2008147871A1 (en) 2007-05-25 2008-05-22 Medical devices, systems and methods for closing perforations

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EP2155071A1 EP2155071A1 (en) 2010-02-24
EP2155071B1 true EP2155071B1 (en) 2014-07-16

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US (1) US9155532B2 (en)
EP (1) EP2155071B1 (en)
JP (1) JP5443341B2 (en)
AU (1) AU2008256823B2 (en)
CA (1) CA2688261C (en)
WO (1) WO2008147871A1 (en)

Families Citing this family (46)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6391048B1 (en) 2000-01-05 2002-05-21 Integrated Vascular Systems, Inc. Integrated vascular device with puncture site closure component and sealant and methods of use
US8758400B2 (en) 2000-01-05 2014-06-24 Integrated Vascular Systems, Inc. Closure system and methods of use
US9579091B2 (en) 2000-01-05 2017-02-28 Integrated Vascular Systems, Inc. Closure system and methods of use
AT361702T (en) 2000-09-08 2007-06-15 Nova Science Ltd Surgical clawer
US6626918B1 (en) 2000-10-06 2003-09-30 Medical Technology Group Apparatus and methods for positioning a vascular sheath
US6623510B2 (en) 2000-12-07 2003-09-23 Integrated Vascular Systems, Inc. Closure device and methods for making and using them
US8690910B2 (en) 2000-12-07 2014-04-08 Integrated Vascular Systems, Inc. Closure device and methods for making and using them
US6749621B2 (en) 2002-02-21 2004-06-15 Integrated Vascular Systems, Inc. Sheath apparatus and methods for delivering a closure device
US7850709B2 (en) 2002-06-04 2010-12-14 Abbott Vascular Inc. Blood vessel closure clip and delivery device
US7905900B2 (en) * 2003-01-30 2011-03-15 Integrated Vascular Systems, Inc. Clip applier and methods of use
US8202293B2 (en) 2003-01-30 2012-06-19 Integrated Vascular Systems, Inc. Clip applier and methods of use
US8398656B2 (en) 2003-01-30 2013-03-19 Integrated Vascular Systems, Inc. Clip applier and methods of use
US9713465B1 (en) * 2004-04-19 2017-07-25 Granit Medical Innovation Llc Surgical closure device and associated method
US8926633B2 (en) 2005-06-24 2015-01-06 Abbott Laboratories Apparatus and method for delivering a closure element
US8313497B2 (en) 2005-07-01 2012-11-20 Abbott Laboratories Clip applier and methods of use
US8556930B2 (en) 2006-06-28 2013-10-15 Abbott Laboratories Vessel closure device
US8893947B2 (en) 2007-12-17 2014-11-25 Abbott Laboratories Clip applier and methods of use
US9282965B2 (en) 2008-05-16 2016-03-15 Abbott Laboratories Apparatus and methods for engaging tissue
EP2344045A1 (en) * 2008-09-16 2011-07-20 Ventralfix, Inc. Method and apparatus for minimally invasive delivery, tensioned deployment and fixation of secondary material prosthetic devices in patient body tissue, including hernia repair within the patient's herniation site
JP5580828B2 (en) * 2008-10-06 2014-08-27 クック メディカル テクノロジーズ エルエルシーCook Medical Technologies Llc End cap for secure deployment of tissue anchors
US8398676B2 (en) 2008-10-30 2013-03-19 Abbott Vascular Inc. Closure device
US9486191B2 (en) 2009-01-09 2016-11-08 Abbott Vascular, Inc. Closure devices
US9089311B2 (en) 2009-01-09 2015-07-28 Abbott Vascular Inc. Vessel closure devices and methods
US9173644B2 (en) 2009-01-09 2015-11-03 Abbott Vascular Inc. Closure devices, systems, and methods
US9414820B2 (en) * 2009-01-09 2016-08-16 Abbott Vascular Inc. Closure devices, systems, and methods
US20100179589A1 (en) 2009-01-09 2010-07-15 Abbott Vascular Inc. Rapidly eroding anchor
US20100185234A1 (en) 2009-01-16 2010-07-22 Abbott Vascular Inc. Closure devices, systems, and methods
US8905937B2 (en) 2009-02-26 2014-12-09 Integrated Vascular Systems, Inc. Methods and apparatus for locating a surface of a body lumen
CA2757494C (en) * 2009-04-03 2013-11-12 Cook Medical Technologies Llc Medical devices, systems, and methods for rapid deployment and fixation of tissue anchors
US20110054492A1 (en) 2009-08-26 2011-03-03 Abbott Laboratories Medical device for repairing a fistula
US9855031B2 (en) 2010-04-13 2018-01-02 Neosurgical Limited Suture delivery system
US20150335320A1 (en) * 2010-04-13 2015-11-26 neoSurgical Ltd. Suture delivery system
EP3305209A1 (en) 2010-06-09 2018-04-11 C.R. Bard Inc. Instruments for delivering transfascial sutures and transfascial suture assemblies.
ITPI20100099A1 (en) * 2010-08-18 2012-02-19 Enrico Gervasi Innovative device for surgical use to employ in the muscle / tendon transplants performed arthroscopically
JP5615112B2 (en) * 2010-09-21 2014-10-29 日本コヴィディエン株式会社 Organ fixing device and organ fixing device
GB2486497B (en) * 2010-12-17 2013-06-19 Neosurgical Ltd Laparoscopic trocar system
GB2495534B (en) * 2011-10-13 2014-04-23 Neosurgical Ltd Laparoscopic system
US9826972B2 (en) 2011-10-24 2017-11-28 C.R. Bard, Inc. Instruments for delivering transfascial sutures, transfascial suture assemblies and methods of transfascial suturing
US9078648B2 (en) 2011-11-07 2015-07-14 C.R. Bard, Inc. Instruments for delivering transfascial sutures and methods of transfascial suturing
US9039721B2 (en) 2011-11-07 2015-05-26 C.R. Bard, Inc. Instruments for delivering transfascial sutures and methods of transfascial suturing
US9924938B2 (en) 2011-11-07 2018-03-27 C.R. Bard, Inc. Instruments for delivering transfascial sutures and methods of transfascial suturing
US9332976B2 (en) 2011-11-30 2016-05-10 Abbott Cardiovascular Systems, Inc. Tissue closure device
WO2013119630A1 (en) * 2012-02-06 2013-08-15 Cook Medical Technologies Llc Artificial device deployment apparatus
US9364209B2 (en) 2012-12-21 2016-06-14 Abbott Cardiovascular Systems, Inc. Articulating suturing device
JP6117160B2 (en) * 2014-09-18 2017-04-19 本田技研工業株式会社 Vehicle braking control device
US9668725B2 (en) * 2015-03-24 2017-06-06 Richard B. Beaven Laparoscopic wound closure device

Family Cites Families (108)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2199025A (en) * 1936-06-08 1940-04-30 Carl E Conn Means and method of closing surgical incisions
US3556079A (en) * 1967-05-16 1971-01-19 Haruo Omizo Method of puncturing a medical instrument under guidance of ultrasound
US4235238A (en) * 1978-05-11 1980-11-25 Olympus Optical Co., Ltd. Apparatus for suturing coeliac tissues
US5417691A (en) * 1982-05-20 1995-05-23 Hayhurst; John O. Apparatus and method for manipulating and anchoring tissue
US5123914A (en) * 1986-05-19 1992-06-23 Cook Incorporated Visceral anchor for visceral wall mobilization
DE69020075T2 (en) * 1989-08-09 1995-11-16 Bard Inc C R Catheter guide and guide wire for conducting a rapid catheter exchange.
US5203787A (en) * 1990-11-19 1993-04-20 Biomet, Inc. Suture retaining arrangement
US5366480A (en) * 1990-12-24 1994-11-22 American Cyanamid Company Synthetic elastomeric buttressing pledget
US5333624A (en) * 1992-02-24 1994-08-02 United States Surgical Corporation Surgical attaching apparatus
DE4235506A1 (en) * 1992-10-21 1994-04-28 Bavaria Med Tech Catheter for injection of drugs
IL103737A (en) * 1992-11-13 1997-02-18 Technion Res & Dev Foundation Stapler device particularly useful in medical suturing
US5403348A (en) * 1993-05-14 1995-04-04 Bonutti; Peter M. Suture anchor
IT1269443B (en) * 1994-01-19 1997-04-01 Stefano Nazari Vascular prosthesis for the substitution or the inner lining of blood vessels medium and large diameter and the device for its application without interruption of the blood flow
GB2298368B (en) * 1995-02-22 1999-01-20 John Francis Cockburn Medical needle assembly for use in ultrasound imaging
US5807304A (en) * 1995-03-09 1998-09-15 Cockburn; John F. Medical needle for use in ultrasound imaging
US6132438A (en) * 1995-06-07 2000-10-17 Ep Technologies, Inc. Devices for installing stasis reducing means in body tissue
US5690656A (en) * 1995-06-27 1997-11-25 Cook Incorporated Method and apparatus for creating abdominal visceral anastomoses
US5810848A (en) * 1996-08-21 1998-09-22 Hayhurst; John O. Suturing system
US6053871A (en) * 1997-01-21 2000-04-25 William Cook Australia Pty. Ltd Calibrated hollow probe for use with ultrasound imaging
US5891159A (en) * 1997-05-02 1999-04-06 Cardiothoratic Systems, Inc. Automatic purse string suture device
US5908428A (en) * 1997-05-27 1999-06-01 United States Surgical Corporation Stitching devices for heart valve replacement surgery
US6071292A (en) 1997-06-28 2000-06-06 Transvascular, Inc. Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures
US5954732A (en) * 1997-09-10 1999-09-21 Hart; Charles C. Suturing apparatus and method
US6078831A (en) * 1997-09-29 2000-06-20 Scimed Life Systems, Inc. Intravascular imaging guidewire
CA2320097C (en) * 1998-12-09 2009-04-14 Cook Incorporated Hollow, curved, superelastic medical needle
US6110183A (en) * 1998-12-22 2000-08-29 Cook Incorporated Suture anchor device
US6398796B2 (en) * 1999-07-13 2002-06-04 Scion Cardio-Vascular, Inc. Suture with toggle and delivery system
JP4108882B2 (en) * 1999-08-04 2008-06-25 オリンパス株式会社 Endoscope wall fixture
US6635073B2 (en) * 2000-05-03 2003-10-21 Peter M. Bonutti Method of securing body tissue
US6358197B1 (en) * 1999-08-13 2002-03-19 Enteric Medical Technologies, Inc. Apparatus for forming implants in gastrointestinal tract and kit for use therewith
US6231561B1 (en) * 1999-09-20 2001-05-15 Appriva Medical, Inc. Method and apparatus for closing a body lumen
EP1261282B1 (en) 2000-03-03 2013-09-25 C. R. Bard, Inc. Endoscopic tissue apposition device with multiple suction ports
US6572629B2 (en) * 2000-08-17 2003-06-03 Johns Hopkins University Gastric reduction endoscopy
US6638275B1 (en) * 2000-10-05 2003-10-28 Medironic, Inc. Bipolar ablation apparatus and method
US20050246023A1 (en) * 2001-02-13 2005-11-03 Yeung Jeffrey E Disc shunt for treating back pain
AU2002257915B2 (en) * 2001-05-18 2007-05-10 Ucl Biomedica Plc A flexible device for transfixing and joining tissue
US20030225312A1 (en) * 2002-03-18 2003-12-04 Anthony Kalloo Endoscopic system for treating inside of body cavity
US6699263B2 (en) * 2002-04-05 2004-03-02 Cook Incorporated Sliding suture anchor
US7494496B2 (en) * 2002-05-17 2009-02-24 Ucl Biomedica Plc Device for transfixing and joining tissue
JP4373146B2 (en) * 2002-07-11 2009-11-25 オリンパス株式会社 Endoscopic suturing device
WO2005110280A2 (en) * 2004-05-07 2005-11-24 Valentx, Inc. Devices and methods for attaching an endolumenal gastrointestinal implant
US7416554B2 (en) * 2002-12-11 2008-08-26 Usgi Medical Inc Apparatus and methods for forming and securing gastrointestinal tissue folds
US9314235B2 (en) * 2003-02-05 2016-04-19 Smith & Nephew, Inc. Tissue anchor and insertion tool
US7431694B2 (en) * 2003-05-16 2008-10-07 Ethicon Endo-Surgery, Inc. Method of guiding medical devices
JP4145200B2 (en) * 2003-06-06 2008-09-03 オリンパス株式会社 Suture device
US7481826B2 (en) * 2003-09-30 2009-01-27 Ethicon, Inc. Fluid emitting suture needle
US7217279B2 (en) * 2003-11-14 2007-05-15 Ethicon, Inc. Suture loop anchor
JP4217587B2 (en) 2003-11-26 2009-02-04 オリンパス株式会社 Endoscope cap
EP1702569B1 (en) 2004-01-08 2015-10-14 Olympus Corporation Anastomosis device and method of excising wall portion of in vivo luminal organ
US20050154401A1 (en) * 2004-01-08 2005-07-14 Scimed Life Systems, Inc. Suturing device for implantable device
JP3799612B2 (en) * 2004-03-22 2006-07-19 フジノン株式会社 Ultrasound endoscope device
JP4643328B2 (en) * 2004-04-07 2011-03-02 オリンパス株式会社 Medical ligature suturing device
JP4923231B2 (en) * 2004-04-15 2012-04-25 クック メディカル テクノロジーズ エルエルシーCook Medical Technologies Llc Endoscopic surgical access instrument and method for articulating an external accessory channel
US7736374B2 (en) 2004-05-07 2010-06-15 Usgi Medical, Inc. Tissue manipulation and securement system
US7390329B2 (en) * 2004-05-07 2008-06-24 Usgi Medical, Inc. Methods for grasping and cinching tissue anchors
US8216252B2 (en) 2004-05-07 2012-07-10 Usgi Medical, Inc. Tissue manipulation and securement system
US8444657B2 (en) 2004-05-07 2013-05-21 Usgi Medical, Inc. Apparatus and methods for rapid deployment of tissue anchors
US7361180B2 (en) * 2004-05-07 2008-04-22 Usgi Medical, Inc. Apparatus for manipulating and securing tissue
US20060015125A1 (en) * 2004-05-07 2006-01-19 Paul Swain Devices and methods for gastric surgery
US8388653B2 (en) * 2004-05-14 2013-03-05 Ethicon Endo-Surgery, Inc. T-type suture anchoring devices and methods of using same
US20060004409A1 (en) * 2004-05-14 2006-01-05 Nobis Rudolph H Devices for locking and/or cutting a suture
US8475476B2 (en) * 2004-06-01 2013-07-02 Cook Medical Technologies Llc System and method for accessing a body cavity
US7678135B2 (en) * 2004-06-09 2010-03-16 Usgi Medical, Inc. Compressible tissue anchor assemblies
US8206417B2 (en) 2004-06-09 2012-06-26 Usgi Medical Inc. Apparatus and methods for optimizing anchoring force
US7931661B2 (en) 2004-06-14 2011-04-26 Usgi Medical, Inc. Apparatus and methods for performing transluminal gastrointestinal procedures
US20060020274A1 (en) * 2004-07-23 2006-01-26 Usgi Medical Inc. Manipulatable grasping needle
EP2353494B1 (en) * 2005-02-08 2014-07-30 Koninklijke Philips N.V. System for percutaneous glossoplasty
JP4592007B2 (en) * 2005-02-15 2010-12-01 Hoya株式会社 Object internal treatment device and object internal treatment system
JP2006288755A (en) 2005-04-11 2006-10-26 Olympus Medical Systems Corp Medical treatment device
US8663236B2 (en) * 2005-04-26 2014-03-04 Usgi Medical Inc. Transgastric abdominal access
US20060237023A1 (en) * 2005-04-26 2006-10-26 Usgi Medical Inc. Transgastric tubal ligation
US9585651B2 (en) 2005-05-26 2017-03-07 Usgi Medical, Inc. Methods and apparatus for securing and deploying tissue anchors
US8628541B2 (en) 2005-05-26 2014-01-14 Usgi Medical, Inc. Methods and apparatus for securing and deploying tissue anchors
DE602006010370D1 (en) * 2005-06-02 2009-12-24 Cordis Corp Device for closing a patent forms ovale
US20070038232A1 (en) * 2005-08-12 2007-02-15 Kraemer Stefan J M Apparatus and method for securing the stomach to the diaphragm for use, for example, in treating hiatal hernias and gastroesophageal reflux disease
US20070060929A1 (en) 2005-09-13 2007-03-15 Norio Onishi Treating implement cartridge of living body tissue
US7875041B2 (en) * 2005-09-28 2011-01-25 Olympus Medical Systems Corp. Suturing method for penetrating hole
US20070123840A1 (en) * 2005-10-18 2007-05-31 Usgi Medical, Inc. Instrument assisted abdominal access
US20070112362A1 (en) * 2005-11-14 2007-05-17 Olympus Medical Systems Corp. Perforation suturing method
US8721657B2 (en) * 2006-01-13 2014-05-13 Olympus Medical Systems Corp. Medical instrument
US8728121B2 (en) * 2006-01-13 2014-05-20 Olympus Medical Systems Corp. Puncture needle and medical procedure using puncture needle that is performed via natural orifice
US20070219411A1 (en) * 2006-01-13 2007-09-20 Olympus Medical Systems Corp. Overtube and endoscopic treatment system
US20080255422A1 (en) * 2006-01-13 2008-10-16 Olympus Medical Systems Corp. Medical device
ITMI20060443A1 (en) * 2006-03-13 2007-09-14 Ethicon Endo Surgery Inc Device for the manipulation of body tissue
US7951161B2 (en) 2006-05-09 2011-05-31 Medrad, Inc. Atherectomy system having a variably exposed cutter
WO2007136820A2 (en) 2006-05-18 2007-11-29 Aponos Medical Corp. Multifunctional instrument introducer
US7758598B2 (en) 2006-05-19 2010-07-20 Ethicon Endo-Surgery, Inc. Combination knotting element and suture anchor applicator
US7736376B2 (en) 2006-07-05 2010-06-15 Olympus Medical Systems Corp. Living body wall fixing tool used in endoscope
US8870916B2 (en) * 2006-07-07 2014-10-28 USGI Medical, Inc Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use
US20080097152A1 (en) * 2006-07-20 2008-04-24 David Stefanchik Braided endoscope accessories
US7837455B2 (en) * 2006-07-28 2010-11-23 Ethicon, Inc. Apparatus and method for making suture packages
US8007432B2 (en) * 2007-01-26 2011-08-30 Ethicon Endo-Surgery, Inc. Endoscopic accessory control mechanism
US8460314B2 (en) * 2007-02-26 2013-06-11 Olympus Medical Systems Corp. Application of procedure through natural orifice
US20080208214A1 (en) * 2007-02-26 2008-08-28 Olympus Medical Systems Corp. Applicator and tissue fastening method through natural orifice
US8128657B2 (en) * 2007-02-27 2012-03-06 Olympus Medical Systems Corp. Suture instrument
US8308766B2 (en) * 2007-02-27 2012-11-13 Olympus Medical Systems Corp. Endoscopic treatment instrument
US7780702B2 (en) * 2007-02-27 2010-08-24 Olympus Medical Systems Corp. Suture tool
US7815662B2 (en) * 2007-03-08 2010-10-19 Ethicon Endo-Surgery, Inc. Surgical suture anchors and deployment device
US20080228203A1 (en) * 2007-03-15 2008-09-18 Minos Medical System and method for translumenal closure in natural orifice surgery
US20080262525A1 (en) * 2007-04-17 2008-10-23 Usgi Medical, Inc. Tissue penetration and grasping apparatus
US7967741B2 (en) 2007-05-01 2011-06-28 Ethicon Endo-Surgery, Inc. Endoscopic guide device
US7967842B2 (en) 2007-06-01 2011-06-28 Ethicon Endo-Surgery, Inc. Integrated securement and closure apparatus
US8088062B2 (en) * 2007-06-28 2012-01-03 Ethicon Endo-Surgery, Inc. Interchangeable endoscopic end effectors
US8992569B2 (en) * 2007-06-29 2015-03-31 Ethicon Endo-Surgery, Inc. Insertion device and method of use
US8128592B2 (en) * 2007-07-11 2012-03-06 Apollo Endosurgery, Inc. Methods and systems for performing submucosal medical procedures
US8771314B2 (en) * 2007-09-28 2014-07-08 Ethicon, Inc. Surgical anchor device
US7998150B2 (en) * 2007-09-28 2011-08-16 Olympus Medical Systems Corp. Suturing device
US20090149714A1 (en) * 2007-12-05 2009-06-11 Frank Bonadio Surgical devices and methods

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EP2155071A1 (en) 2010-02-24
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CA2688261C (en) 2013-04-30
JP2010527744A (en) 2010-08-19
AU2008256823A1 (en) 2008-12-04
AU2008256823B2 (en) 2013-09-12
US20080294001A1 (en) 2008-11-27
CA2688261A1 (en) 2008-12-04
JP5443341B2 (en) 2014-03-19

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